Not so emergent...

Well, about halfway through my ER rotation and I can safely say I wouldn't be much good as an ER doc. There are things I like about the ER--you really do get the chance to save lives, whether it is by doing CPR or intubating someone in respiratory distress--but there are a lot of things that I wouldn't handle so well...

First, it's too raw. People are often in bad shape and that encompasses quite a spectrum of things. Some come in with foot, mouth or body odor so foul, you feel like someone knocked you in the nose and stuffed rotten eggs down them. Others walk in covered in blood or vomit, sometimes both, and you are almost afraid to touch them lest they pour forth right on to you. Still others are intoxicated, on a variety of substances, and you spend half your time worrying whether or not they're going to punch you as you calm them down enough to, hopefully, save their life. And then there is the schizophrenic who came in and told me was is lucifer. There are also whiners, people who are in relatively good shape but seem to think they will get better faster if they continuously complain. I just want to tell them sometimes, "Look buddy, you think you got it bad, have a look two beds down and you'll know what it means to be sick. Go home and thank God you're not in his shoes."

Second, it's the nonlinear way things work. You have like 3 or 4 patients with important stuff going on at the same time, and you have to keep track of everything. One patient could be in diabetic ketoacidosis, another not very responsive because of alcohol overdose and everyone else complaining of pain. You're at the center of all the activity, having to motivate some of your staff to do things while also talking to other physicians, family members and educating your patients. I often feel like getting up in the middle of the madness and saying, "Oh yeah people, what about me? Anyone want to know how I'm doing?" To be a great ER doc, you really have to be selfless, patient and nonjudgemental, more so than in other specialties...

Third, the schedule is all off. Even though, if you look at total hours worked in the month, it is probably less than many other specialties, you work them in shifts, which can be at different times of the day. So your biological clock is always getting set and reset and things that hold meaning for others (like the weekend) lose meaning for you, because your day off may be Tuesday and Wednesday. I don't know, it's weird, you are like on an alternate timeline from the rest of humanity. It feels strange...thank God I don't have any overnight shifts left...

I can see how the pace, intensity and even the schedule appeals to some, but I'm not cut up for it...it does make for some great stories, I'll try and post some of my more interesting patient encounters...